Our commitment is to deliver top-tier health care to our patients, prioritising your vision, safety and clinical needs. Equipped with cutting-edge technology and staffed by experienced professionals, the practice ensures a supportive and secure environment.
Our fees are structured to provide quality eye health care while minimising out-of-pocket expenses for our patients. Medicare and Private Health Fund rebates vary depending on several factors, which we give in further detail below.
Consultation Fees
At your initial consultation a $205 fee is charged, and Medicare may subsidise approximately $80-180 of this fee. The consultation fee can vary depending on the consultation type and duration, ensuring adequate time for each patient’s needs. At the time of booking, our reception staff will inform you of the cost of the initial consultation. Occasionally further tests using specialised medical equipment are required to fully assess your condition, and these vary from patient to patient and are unfortunately difficult to predict prior to the appointment. Subsequent consultation fees may be applicable for further visits, and vary based on factors such as follow-up type and referral validity. Medicare subsidises part of these fees (for non-cosmetic consultations) provided there is still a relevant and current referral.
After your consultation, we will be able to provide you with an estimated cost of any procedures recommended to you by your surgeon.
Operation Fees in Hospital
The cost of each operation is personalised, with estimates provided after your initial consultation. Costs encompass hospital fees, including accommodation and theatre expenses, and medical practitioners’ fees, such as surgeons, anaesthetists, radiologists, and pathologists. Generally a deposit will be required to secure a surgical booking.
Surgical fees cover the operation, post-operative care during the recommended post-operative period (up to 3 weeks depending on the procedure), and necessary items such as intraocular lenses or prostheses. Fees may vary based on surgical complexity and any necessary but unforeseen procedures during surgery.
Surgery – Private Health Insured
If you have been confirmed to have surgery and have private health insurance, then you may be eligible for partial cover for your procedure (see Medicare Rebates and Other Subsidies below). The LVF Eye Centre will estimate the costs involved for your surgeon, including your rebate and any out-of-pocket expenses.
As a guide, the average out-of-pocket expense for insured patents in 2023 for a medically necessary intraocular procedure like a basic cataract procedure was $500, whilst a medically necessary premium cataract procedure was $1,932.
Surgery – Uninsured
Slightly less than half our patients who require surgery do not have private health insurance, and we still provide options for these patients to access first class care at the centre. Options include the following:
Private Uninsured: Medicare will cover a portion of the surgeons and anesthetists fee only. The hospital fee is paid fully by the patient. Most patients who have chosen to save for their health needs instead of paying insurance premiums take this option.
Pensioner Uninsured: Medicare will cover a portion of the surgeons and anesthetists fees and there is a concession for Pension Card holders.
Public: We are always happy to refer patients for surgery in the public health system. This surgery is fully covered by the government. The general waiting time for ophthalmic surgery is 12+ months, however the most important consideration is that the available protheses and lenses to be implanted into your eyes are limited and there is no guarantee that your surgery will be performed by a qualified ophthalmologist.
Outpatient Procedures
Procedures performed in our facility’s procedure room are considered outpatient procedures, and fees cover surgical and facility fees. Medicare rebates apply to surgical fees, while facility fees are payable on the day. Administered drugs still need to be purchased from a pharmacy. Outpatient procedures are recommended only when safe and are performed for various reasons, including minimising downtime and avoiding hospital fees.
Medicare Rebates and other subsidies
Medicare and Private Health Insurance subsidies reduce out of pocket expenses, and coverage varies based on admission status and procedure type. The Medicare Benefits Schedule (MBS) sets fee schedules for medical services (the coded item number) and is used to calculate the Medicare rebate (subsidy) paid to patients for the cost of medical services. For patients not currently admitted to hospital, the Medicare rebate is 85% of the MBS Fee. For patients who are admitted to hospital (either as day surgery or overnight in-patient), the Medicare rebate is 75% of the MBS Fee.
If a patient is admitted to hospital, and is privately insured, the government allows your private health fund (PHF) to pay the hospital fee (which is often very substantial) and make a further contribution of 25% of the MBS fee for services provided in hospital (on top of your Medicare rebate). By law, your private health insurance cannot contribute to medical services provided to you as an outpatient.
Unfortunately, Medicare and PHF rebates have not kept pace with the rising costs of running a medical practice for decades. For the practice to ensure that we continue to provide the quality of services which our patients expect, and to maintain the highest standards of safety for our patient’s clinical care, we have now become unable to ‘bulk bill’ patients. However our fees continue to align with the Australian Medical Association (AMA) suggested fee schedule, reflecting the quality clinical care and facility standards we provide, and the costs involved in equipping and running our facilities. Therefore, due to the costs of running a high-quality medical practice, there can potentially still be a gap, or out of pocket expense to the patient after the Medicare and Private Health Rebate. The gap payment varies very substantially depending on who you are insured with and the level of cover you hold.
Payments and Receipts
Payment of your initial consultation and any medically necessary tests is due at the time of consultation. If you require surgery, a deposit is paid on booking and an invoice for the remaining fee will be issued once the surgery is complete, with payment due within seven days. Once payment has been made a receipt will be issued for record-keeping and rebate claims.